Practices are required to identify newly-registered patients aged 16 or over drinking at increased or higher levels using either the FAST or AUDIT-C tools.
Once identified patients should receive simple brief advice and referred to specialist services where appropriate. These patients should also be assessed for anxiety and/or depression and provided with treatment or advice.
- Screening applies to all patients registered within the financial year who are aged 16 or over at the time the short case finding test is applied.
- Practices are required to screen patients using either the FAST or AUDIT-C tools which each take about one minute to complete. A score of 3 or more with FAST and 5 or more with AUDIT-C is regarded as positive.
- All patients with a positive score should be screened using the remaining questions in the 10-question AUDIT questionnaire to establish if increasing, higher risk or likely dependent drinking
- 0-7 indicates sensible or lower risk drinking
- 8-15 is increasing risk drinking
- 16-19 is higher risk drinking
- 20 and over indicates possible alcohol dependence
- Practices should add a value to the field associated with the code in the patient’s record.
- Patients scoring between 8 and 15 should be offered brief intervention, those with a score of 16 to 19 should be offered brief intervention or brief lifestyle counselling (20-30 minutes), or be referred to a community-based counselling service.
- The recommended brief advice should take around 5 minutes. Click here for details and see ‘other resources’ below for patient literature to support this.
- Patients with a score of over 20 should be considered for referral to specialist services.
- Those identified as drinking at increasing or higher levels (scoring 8 or more) should be offered an assessment for anxiety and/or depression using questionnaires such as the Generalised Anxiety Disorder Scale-7 (GADS-7) and/or Patient Health Questionnaire (PHQ-9).
- Patients found suffering from anxiety and/or depression should be provided with treatment and support as appropriate, which may include therapy, counseling and medication.
- In severe cases referral to specialist mental health services may be appropriate.
|Read v2||Read CTV3|
|Alcohol – initial screening|
|FAST alcohol screening test||388u.||XaNO9|
|Alcohol use disorder identification test consumption questionnaire||38D4.||XaORP|
|Alcohol assessment declined - enhanced services administration||9k19.||XaPKl|
|Alcohol consumption screening test declined
There are no codes available which indicate a positive FAST or AUDIT-C test result. Practices should add a value to a field associated with the code. A value of three or more is regarded as positive for FAST and a value of five or more is regarded as positive for AUDIT-C.
|Alcohol – Full screening|
|Alcohol use disorders identification test||38D3.||XM0aD|
|Alcohol use disorders identification test declined||8IH4.
Practices are required to add a value to a field associated with the code to record the score. The score are as follows:
|Alcohol - intervention
|Brief intervention for excessive alcohol consumption completed||9k1A.||XaPPv|
|Extended intervention for excessive alcohol consumption completed||9k1B.||XaPPy|
|Referral to specialist alcohol treatment service||8HkG.||XaORR|
|Brief intervention for excessive alcohol consumption declined||8IAF.||XaPty|
|Extended intervention for excessive alcohol consumption declined||8IAt.||XaX4s|
|Declined referral to specialist alcohol treatment service||8IAJ.||XaPwp|
|Anxiety and depression
|Anxiety screening using questions||68970||Xab9F|
|Depression screening using questions||6896.||XaLIc|
|Generalised anxiety disorder 2 scale||38QN.||XaZJQ|
|Generalised anxiety disorder 7 item score||388w.||XaNkT|
|Patient health questionnaire (PHQ-9) score||388f.||XaLDN|
|HAD scale: depression score||388P.||XaIwf|
|Beck depression inventory second edition score||388g.||XaLLG|
|Patient given advice about management of anxiety||Xab9Gpneumoc||8CAZ0|
|Patient given advice about management of depression||8CAa.||XaKEz|
- Literature to support brief advice on the Change4Life website.
- Download the 2017/18 technical requirements for the GMS contract changes